Anterior segment optical coherence tomography assisted excimer laser phototherapeutic keratectomy for fungal corneal ulcer / 眼科新进展

ABSTRACT

Objective To assess the treatment outcomes of anterior segment optical coherence tomography(OCT) assisted excimer laser phototherapeutic keratectomy (PTK) for fungal corneal ulcer.Methods Twenty-four patients (24 eyes) suffered from fungal corneal keratitis were collected by a retrospecive chart review with at least 6 months of follow-up data available.All corneal ulcer depth did not exceed 1/3 corneal thickness and were resistant to local and systemic medication therapy for at least 1 week.Patients were divided into 2 groups.14 patients with 14 eyes were taken PTK and 10 patients with 10 eyes were treated with lamellar keratectomy.Follow-up time was at least 6 months.Visual acuities,corneal thickness,confocal microscope,healing of the epithelial defect and inflammation and complications were recorded.Results The postoperative visual acuity in two groups were significantly improved,visual acuity of PTK treatment group improved significantly better than the control group (P ＜ 0.05).Healing time of PTK treatment group (19.43 ± 5.68) days was shorter than that of the control group (34.40 ± 5.38) days,the difference was statistically significant (P ＜0.05).There was no significant difference in the residual central corneal thickness between the PTK treatment group and the control group (P ＞ 0.05).Residual mycelium after operation in the treatment group was significantly decreased than that of control group.Healing time of epithelial in PTK treatment group (4.0 ± 1.1) days was shorter than that of the control group (6.20 ± 1.39) days,the difference was statistically significant (P ＜ 0.05).There was no corneal dilation in two groups.No recurrence in PTK treatment group was occurred.3 cases in control group had recurrence after 6 months,drug control was effective in 1 case,and other 2 cases undertook corneal transplantation.Conclusion Anterior segment OCT assisted PTK for corneal ulcer can effectively clear the lesion,accelerate epithelial healing,provide a new choice for the treatment of early superficial fungal corneal ulcer.